Step Response of Human Motor System as a Measure of Postural Stability in Children

Postural sway is a product of the neuromuscular system that is commonly used in contemporary labs and clinics for the assessment of postural stability. In this study, we analyzed the transient responses of the neuromuscular system during the rise-on-toes (ROT) movement in eighteen 11 yrs old girls. Their center of pressure (COP) trajectories were recorded with standard force-platform during the transition from quiet stance to standing on toes. To assess the robustness of children's postural stability, we compared the ROT trajectories while the movement was performed with and without vision. Our results confirmed that the dynamic characteristics of the COP step response were significantly modified by visual feedback. In particular, the ROT test performed with eyes closed (EC) was characterized by a four-fold increase of COP chaotic oscillations at the target (tiptoe) position. This resulted in a substantial increase in the movement's index of difficulty (ID) thus to achieve adequate accuracy of the target-oriented movement the COP velocity was decreased accordingly. This inherent strategy of the brain controller allowed for precise positioning of the COP within the reduced size of the target. In conclusion, the dynamics of the ROT movement is always precisely adjusted to the stability of the upright posture, and thus, the dynamic characteristics of the COP step response are also sensitive measures of postural stability and the ROT can be recommended as a useful test for this assessment in the general population.